Literature Review

Heart disease tops US mortality in 2024, CDC reports McKnights Long-Term Care News; by Foster Stubbs; 9/12/25 The leading causes of death in the United States in 2024 were heart disease, cancer and unintentional injury, the Centers for Disease Control and Prevention said in a September report. ... In total, there were 3,072,039 total deaths that occurred in the US in 2024 with a death rate of 722.0 per 100,000 people. This was 3.8% lower than the totals in 2023. Death rates also decreased for all race and ethnicity groups but rates for Black people remain higher than those for all other groups. Overall, death rates were highest for males, older adults and Black people, demonstrating a need for further examination of the health of these demographic groups. Heart disease caused 683,037 deaths, cancer caused 619,812 deaths and unintentional injury resulted in 196,488 deaths. Mortality statistics were collected by The National Center for Health Statistics’ (NCHS) National Vital Statistics System (NVSS) using US death certificate data. [The CDC Report is at Vital Statistics Rapid Release, Number 039, September 2025.]

Has human life expectancy already peaked?Vice; by Luis Prada; 9/10/25 For most of the 20th century, human life expectancy skyrocketed. Advancements in hygiene science, a wide variety of medical innovations and discoveries ... have all helped our collective life expectancies tremendously. According to a new study, however, we may have topped out. In the study, published in PNAS and spotted by Science Alert, an international team of researchers crunched the numbers on people born between 1939 and 2000 in 23 high-income countries, using six different forecasting models.Editor's Note: I recall a hospice CE conference around 2005, where a healthcare data statistician presented projections on mortality trends. Based on the previous century’s gains, the data suggested that babies born then could live well past 100—with 120 years as a realistic possibility. This new study raises the provocative question of whether those optimistic forecasts may already have reached their limits.

A workflow initiative to increase the early palliative care referral rate in patients with advanced cancer MDedge - Federal Practitioner - Quality Improvement; by Judy Lim, MD and Linda D. Nguyen, DNP, NP-C, MD; 9/3/25 ... The American Society of Clinical Oncology and the World Health Organization recommend that every patient with advanced cancer should be treated by a multidisciplinary palliative care team early in the course of the disease and in conjunction with anticancer treatment. Despite the documented benefits and the recommendations, early PC is still not often offered in clinical practice. 

The role of PMHNPs in palliative psychiatry: An ethical framework for care when remission is unattainableJournal of Hospice and Palliative Nursing; by Trae Stewart; 8/23Patients with serious and persistent mental illness may experience intractable suffering despite exhaustive treatment, challenging the dominant curative paradigm in psychiatry. Palliative psychiatry offers an emerging alternative-prioritizing comfort, dignity, and quality of life when remission is no longer attainable. This article presents a comprehensive ethical and clinical framework for integrating palliative psychiatry into psychiatric-mental health nurse practitioner (PMHNP) practice. Drawing parallels with somatic palliative care, the author explores the theoretical foundations, diagnostic complexities, and ethical imperatives guiding palliative psychiatry. Legal challenges, such as hospice eligibility criteria and involuntary treatment statutes, are also examined, with recommendations for practice and policy reform. Assistant Editor's note: As I search for pertinent articles to add to this newsletter, I am delighted to find so many that address a variety of aspects of palliative care. I see articles on palliative care in the ED, palliative care for special populations, palliative care for transplant patients, and as highlighted in this article, palliative care in psychiatry. It makes me think that maybe, just maybe(!), the many benefits of palliative care are finally being recognized and embraced by mainstream health care.

[Australia] The unmet needs of parents in pediatric palliative care: A qualitative systematic reviewJournal of Palliative Medicine; by Piyumi Senanayake, John Oldroyd; 8/25The goal of pediatric palliative care is to improve the quality of life of children with life-limiting or life-threatening disease and their families through a holistic care approach. Thirteen studies were included [in this analysis]. Five major themes emerged: (1) pediatric palliative care services delivery and care coordination, (2) emotional, psychological, and spiritual support, (3) end-of-life care and bereavement support, (4) practical and daily living support, and (5) communication and information. Parents reported unmet needs in multiple dimensions and wished for more support in caring for their children. Given that all of the unmet needs align with already established pediatric palliative care standards, this review highlights the need for revised health care policies and practices that will lead to better implementation of these standards in practice.

[Canada] How mobile palliative care unit is making a difference Ontario Hospital Association - New Models of Care, Ontario, Canada; Press Release; 9/9/25 Launched earlier this year, the PEGASUS program, short for palliative expertise group for ambulatory support and unified solutions, is an innovative, mobile model of care that brings palliative medicine directly to patients in outpatient clinics across the hospital. Rather than establishing a traditional clinic space, the PEGASUS team “flies” to where the need is. ... The result: a consultation-based team that integrates seamlessly into existing ambulatory clinics, avoiding duplication of services and focusing on enhancing continuity of care. 

Caregiving under the Medicare Hospice Benefit JAMA Internal Medicine - Viewpoint Agind and Health; by Helen P. Knight, MD; Richard E. Leiter, MD, MA; Harry J. Han, MD; 9/8/25 As palliative care physicians, we frequently refer patients to hospice care. When we do so, we often worry about them. How will they and their families manage custodial care—the day in, day out, physical and financial demands of caregiving—on top of navigating the inherent challenges of end of life? We know that high-quality hospice agencies provide patients and their families with invaluable support for symptomatic, emotional, and spiritual needs. But in the US, due to constraints of Medicare reimbursement, hospice agencies provide only limited custodial care support; this lack of assistance often is an unwelcome surprise to our patients and families and profoundly shapes their end-of-life experience.

Raising the standard of Arizona’s dementia care Lovin' Life; by Lin Sue Flood; 9/7/25 Arizona is setting a bold new standard to better support families impacted by dementia. A groundbreaking state mandate requires all memory care facilities to provide up to 12 hours of specialized dementia training to their staff, plus four hours of continuing education each year. This extensive training combines online video modules with hands-on, in-person skills sessions. Hospice of the Valley’s experienced Dementia Team is leading the way as one of the agencies the Arizona Department of Health Services has approved to deliver this comprehensive training. The nonprofit organization is unique in offering it as a free community service.

Training and practice gaps in nursing home palliative care: A cross-sectional study Journal of the American Geriatrics Society (AGS); by Manali Saraiya, Molly A. Nowels, Rose L. Carlson, Jerad H. Moxley, Catherine A. Riffin, Evan Plys, M. Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D. Adelman, Daniel Shalev; 9/7/25 We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. ... Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.

Top ten tips palliative care clinicians should know about intensive care unit consultationJournal of Palliative Medicine; by Ankita Mehta, Karen Bullock, Jillian L. Gustin, Rachel A. Hadler, Judith E. Nelson, William E. Rosa, Jennifer B. Seaman, Shelley E. Varner-Perez, Douglas B. White; 8/25Critical illness and ICU stays can be extremely distressing for patients and their loved ones. Providing palliative care in the ICU, although a standard component of comprehensive care delivery, involves understanding the individual culture of each specific ICU, collaboration with multiple providers, and interfacing with surrogate decision makers while patients may not be able to communicate and are undergoing interventions that are unfamiliar to them and loved ones. These top ten tips aim to support palliative care clinicians providing consultation in ICUs. Specifically, these tips address initial relationship building with ICU clinicians and teams to foster effective collaboration, establishing goals of care by assessing health-related values, explaining treatment options, individualizing prognostic discussions, and managing end-of-life symptoms for patients while in the ICU and throughout ICU discharge transition.

Why palliative care is more than just end-of-life support MedPageToday's KevinMD.com; by Dr. Vishal Parackal; 9/1/25 ... Palliative care as a system requires strong interpersonal and cross-specialty communication for smooth functioning, as patients may require expert opinions from different fields to optimize their treatment plan. Patient education for systemic follow-ups and establishing a baseline of knowledge regarding their diagnosis and potential danger signs helps create a better environment for holistic care. While we focus on the physical aspects of care and diagnosis, we often fail to realize the psychological and mental impact that such conditions can have on the patient and their family. ... The opportunity to make a meaningful difference in patients’ lives by easing their suffering and enhancing their quality of life is profoundly fulfilling. ... Editor's Note: Excellent descriptions of palliative care.

[Global] Palliative care for special populations ehospice; by Howard Kinyua; 9/1/25

Improved outcomes and cost with palliative care in the Emergency Department: Case-control studyThe Western Journal of Emergency Medicine; Brandon Chalfin, Spencer M Salazar, Regina Laico, Susan Hughes, Patrick J Macmillan; 7/25This small pilot case-control study included a subset of all patients referred by emergency physicians and hospitalists for palliative care within 24 hours of registration, physically present in the ED. CONCLUSION: Embedding hybrid physicians in the ED significantly shortened hospital stays and reduced charges for seriously ill patients. A notable secondary outcome was that 26.5% of ED visits in the case group did not result in hospital admission, compared to all controls being admitted ... In addition, more cases than controls had a code status of comfort care at discharge ... These findings support the further exploration of integrating such physicians into ED settings to enhance patient care and optimize hospital resources.